What sort of responses are people getting from their newly souped up Advice and Information services around the country, please?
It’s now a statutory duty under the Care Act for all councils to offer advice and information about the system, as a WHOLE, not just what there is ‘out there’ to offset needs.
So that means telling the general public that social care is there to meet the needs of people who either cannot afford to meet their own, or who cannot manage to organise it.
This might be, for instance, because the person has insufficient mental capacity to run their own finances or make contracts with care agencies or other providers, and have nobody else willing to help them do it or do it, in their place.
This legal right is a right that has long existed, but has been refreshed by the Care Act that’s just come into force. But the issue seems to be that none of us knows what we don’t in fact know – so the adults’ social care safety net is not something most of the population has even heard of, let alone utilised for themselves or their loved ones….
This new duty also means telling people that what one gets ultimately – after a lot of talking and exploring how you might also be helped to help yourself – comes down to what an assessor thinks is needed to meet one’s eligible assessed needs, and that that question – eligibility – is governed by regulations which look at what one can and can’t manage to do. And that for people who aren’t on benefits, there’s almost bound to be a charge for what one is finally offered, because social care is not like NHS care – it IS chargeable, but not for everyone.
The Care Act does offer more hope of getting something that suits the person much better than before though – because it requires – as a matter of law – person-centred and person-led exploration of what would be most effective for the promotion of the actual individual person’s well-being!
Is it better to use the council system, or just rely on the internet, word of mouth, and self-help, then? One might be forgiven for thinking that there’s no point in getting assessed, because one might as well go out and organise one’s own care – no nosey social worker to contend with, no bureaucracy, and the REAL choice from making up one’s own mind.
But remember who we’re talking about here: people who have never needed help before, or whose need for help is suddenly very expensive indeed.
Here are the advantages:
a) through assessment and care planning support, you get help and advice from people who are aware and experienced, and that’s important for families who live far apart, or for a person thrown suddenly into a care crisis.
b) You may get access to networks of other users, even if you are not internet savvy.
c) There is not allowed to be a waiting list for most services or funding, once one has been assessed and a care plan produced – even if the council’s social services coffers are bare. This is the value of living in a country which upholds an attachment to the rule of law, by the way – this duty to meet need is an enforceable duty, and not having the funds allocated for it is NOT a legal excuse. How civilised is that, then?
d) Also, unless one’s council has decided it can no longer afford to subsidise care for people with illness and disability at all, there will likely be a maximum charge within its charging system, which means that however well off one is, putting one’s needs through the local authority still nets some kind of a financial saving, which makes economic sense for most of us.
e) Those lacking sufficient mental capacity in relation to the management of their own finances can have it organised by a regulated vetted service, or have a relative appointed as an Authorised Person without the expense of registering formal Deputyship or the fudging that goes on with Lasting Power of Attorney when it is already too late for the person to understanding the power they are signing away. And when something goes wrong with the actual service, the local authority is the purchaser, unless one has taken a direct payment, so there is the local authority’s purchasing unit on the case, rather than one having to have an argument oneself.
e) And the service, even one that is purchased by the council, is still supposed to be able to be personalised, even if it has been bought in bulk, to save public money.
f) Lastly, if a person’s carer is getting towards the end of their tether, they are able to have their own assessment of eligibility for help (services or money or vouchers – a very wide range of things) to sustain the carer doing what they’re probably best at doing anyway.
Your local advice and information service is supposed to be able to tell you what the difference is between chargeable social care for adults, and NHS Continuing Health Care, which is free – a status applicable to people who would once have been cared for in hospital, and had their NHS services delivered without any charge at all. This can apply to people with terminal illness, even if they do not need a lot of what you and I would call traditional HEALTH care, ie attention from nurses. It can apply to people in nursing homes, even though they are already getting a contribution from the NHS by way of the Free Nursing Care component of their fees. It can apply to people with learning disabilities if for instance, their condition makes them behave in a way that challenges those caring for them.
The advice and information service is also supposed to tell you how the social care system can help people with a housing problem related to illness or disability or a need for supervision – because social services staff are often entitled by way of joint working arrangements with the Housing Authority to boost people’s points on the Housing Register or in the context of applications for homelessness. The service will be able to give advice about the difference between ‘local connection’ and ‘ordinary residence’ – legal concepts that can affect one’s status in the struggle for scarce housing that is suitable for people wiht special needs.
And of course one’s advice and information service OUGHT to be able to tell you whether some of the preventative and not for profit services independently available to ANYONE in the area – regardless of any special referral from the council – have even got vacancies, or would have to charge ‘on the door’, or have a waiting list, or special admission criteria, now that we have, as a nation, elected a government with a clear mandate for more austerity measures.
If nobody bothers to write to their councillors about that problem, to encourage investment spending, now, so as to save money for the future, and if we don’t have this sort of issue properly debated at the Health and Wellbeing Board, we will all have colluded, through apathy, in the mediavalisation of social care standards and capacity. And this, just when we’re going to need it most – when the numbers of dependent people are going to be at their highest for a century… and when most households’ wellbeing demands that every adult member, who possibly can, remains in the outward-facing world of work, at least part-time, rather than taking on an unpaid caring role.
Please post what you think about your local advice and information service, if you’ve had a post Care Act start date experience…